Reporting public
health and medicine
Thomas Abraham
Today’s class
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Introduction to health and medical reporting
Course objectives and course outline
Organizing our course work
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"The observed number of two GBS cases
among vaccinated persons so far lies within
normal expectation of baseline incidence that
would occur in a population of 170,000
(regardless of vaccination history), adjusted
for age and seasonal effects," the spokesman
said.
This is about life and death
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Experts are often divided
There are often commercial, political and
personal interests at play
The public depend on you for information on
which they can act
Life and death at a global level:
global health issues
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“AIDS is not just another public health
threat, but now belongs in the league of
make-or break issues of our times-together
with mass poverty, climate change and
terrorism.” Peter Piot, former head of
UNAIDS
Today, 12,000 people are likely to be infected
with HIV/AIDS and 6,000 are likely to die
http://www.globalhealthfacts.org/topic.jsp?i=1#table
Other diseases
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2,500 children, mostly under the age of five,
are likely to die today in sub Saharan Africa
of malaria.
Diarrhoeal disease kills 1.5 million children
every year.
Tuberculosis kills 1.8 million people a year
By reporting on these issues, intelligently
journalism can persuade governments to take
action
Why study health and medical
reporting?
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If you are good at it, you can make a
difference!
Three areas of health and
medical reporting
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Health policy
Medicine
Public health
1. Health policy
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How should health care be provided? By the
government, or by private businesses and
foundations?
Should the cost of health care be borne by
individuals, or by society as a whole?
Should all members of a society have a right to
health care regardless of their ability to pay?
How much should a society spend on health
care?
2. Medical reporting
Largely about new treatments for diseases
 Three main sources
-articles in scientific journals
-scientific conferences
-press conferences by scientists
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The challenges of medical
reporting
1.
Understanding and interpreting medical
trials, and the principles of evidence based
medicine
http://www.cbsnews.com/video/watch/?id
=7123744n&tag=cbsnewsSectionsArea.3
Understanding the power of
money
2. Understanding the power of money: the
global pharmaceutical industry is a US $500
billion dollar a year industry, facing severe
competitive, regulatory and economic
pressures
http://www.youtube.com/watch?v=lNFuEcy5e
kg
Understanding the power of
money
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“Some of the expensive drugs available today
have only modest therapeutic benefits, while
many inexpensive medicines are highly
effective and safe.”
“Manufacturers provide a stream of new
products for the medicines market place,
usually at higher prices than existing
products.”
WHO Report “The World’s Medicines Situation
Understanding the power of
money
Medical research is fuelled by money:
-from industry
-from foundations
-from governments and public money
 Even scientific journals are commercial
enterprises
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3. Public health
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Public health is concerned with the health of
communities and societies
Clinical medicine on the other hand focuses on
disease in individual patients
Public health studies ways to improve community
health through disease prevention
Public health interventions to improve community
health include improving sanitation, promoting
healthier lifestyles, vaccinations etc.
Some definitions of public
health
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“The science and art of preventing disease,
prolonging life and promoting health
through the organised efforts of society” Sir
Donald Acheson
“What we as a society do collectively to
assure the conditions in which people can be
healthy” Institute of Medicine. USA
Which of these headlines is about
public health, and which is not?
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“Government unveils new measures to reduce road
side pollution”
“New surgical treatment increases success rate of
liver transplants”
“Vietnam announces fresh outbreak of bird flu”
“Outbreak of diarrhoea forces kindergarten closure”
“New drug dramatically reduces high blood
pressure”
John Snow (1813-1858) and
public health
Cholera
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From around 1830, Britain and Europe were struck
by several waves of cholera, causing hundreds of
thousands of deaths
In those days, doctors believed that cholera was
caused by “miasma” or poisonous gases from sewers
and swamps.
Snow was not convinced- why did coal miners who
worked far from sewers get cholera? Also, the first
symptoms were always digestive- so he thought it
must be to do with food or water
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Snow became convinced the water supply was
responsible
During an outbreak in 1853, he studied the water
supply to 44 households with cholera cases.
He knew that all residences in London were supplied
by one of two water companies.
Company A drew its water from a section of the
Thames river polluted with sewage
Company B drew its water from a section of the river
that was farther away from the city and less polluted
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Snow went to each house and where there had been
a death and asked which company they got their
water from
He found that 38 of 44 cases were in houses that got
their water from Company A
He expanded his study to 334 cases, and found that
286 had their water from company A
Snow thought he had “very strong evidence of the
influence that which drinking water containing
sewage has on the spread of cholera”
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Snow’s critics were not impressed-there was
no evidence of any kind of infectious agent in
the water
Snow’s technique- collecting data on the
incidence and distribution of a disease to
determine probable cause, is a basis of
modern epidemiology
Snow’s vindication
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In August 1853, Cholera broke out on Broad Street,
close to Snow’s home in London.
He noticed that most of the fatalities were close to a
public water pump on the street.
He got a list of all the victims, and calculated the
distance from their houses to the pump
73 of 83 deaths were in homes closer to the Broad
Street pump than any other pump.
Of the 10 remaining, 8 had drunk at the pump- some
were children who used to drink at the pump on the
way to school
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Snow persuaded health authorities to remove
the handle from the pump so it could not be
used- cases of cholera decreased.
Importantly- also established that those
living close by who had a separate source of
water did not fall ill.
Logical principles behind epidemiology that
Snow demonstrated
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Cause of a disease will lead to higher rates of
illness among those exposed to the cause,
then those not exposed
Cause can be found by analysing patterns of
occurrence of the disease in a population
http://www.ph.ucla.edu/epi/snow/snowbook.htm
The Broad Street pump
Reading
For more on Snow
http://www.ph.ucla.edu/epi/snow.html
 Read Wikipedia entry on public health
http://en.wikipedia.org/wiki/Public_health
 Visit the website of the Centre for Health
Protection in Hong Kong (www.chp.gov.hk) and
get an idea of what the major communicable
diseases are in Hong Kong, average life
expectancy, major causes of death etc.
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The demand for health and
medical journalism
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http://www.reuters.com/news/health
http://www.bbc.co.uk/news/health/
http://www.nytimes.com/pages/health/index.html
http://www.cbsnews.com/2718-500202_162-489.html?tag=related
www.bmj.com
www.thelancet.com
http://www.kaiserhealthnews.org/
http://www.cidrap.umn.edu/
Course objectives
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To get a broad understanding of public health, the scope
of public health reporting, possible careers in public
health reporting.
To understand the principles of good public health and
medical reporting
To understand the sources of scientific and health
information and how to use them
To learn to understand and interpret scientific and
health information and turn them into clear, intelligent
news reports.
Home work
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Sign up for news alerts with ProMed(www.promed.org), the Lancet
(www.thelancet.com), the New England
Journal of Medicine, Science and Nature
Follow the Eurekalert web site
http://www.eurekalert.org
Course work
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You will chose a topic in medicine or public
health you are interested in ( ie cancer,
HIV/AIDS, influenza, mental illnesses etc)
and write 3 stories of around 400-500 words
each based on a paper in a scientific journal
(40% of grade)
You will complete on line courses in
HIV/AIDS, tuberculosis and malaria at
http://www.globalhealthlearning.org/login.cf
m ( 40% of grade)
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You will read and review one book written for
a general audience on a medical or health
topic (list of books will be distributed in
class)
Deadlines and details in the next class..